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University of Rochester Credentials Support Specialist - 228239 in Rochester, New York

Credentials Support Specialist Job ID 228239

Location Medical Faculty Group Full/Part Time Full-Time Favorite Job Regular/Temporary Regular Opening

Part Time 20 hours Grade 009 URMC Medical Staff Services

Responsibilities

Work Location: Remote/Home preferred

Position Summary:

The Credentials Support Specialist (CSS) serves as a Medical Staff Services Professional responsible for the administrative duties required in the credentialing process for the initial and re-appointment applicants of the Allied Professional or Medical Staff of the University of Rochester’s affiliated hospitals and/or the clients of the of the University’s Centralized Verification Organization. The applicants include various types of healthcare practitioners including but not limited to physicians, dentists, physician assistants, and nurse practitioners.

The CSS enters and maintains specialized applicant information into a complex credentialing software database and obtains information related to the practitioner’s credentials and background. The CVS is also responsible for the accuracy and integrity of the credentialing database system and related applications.

The CVS ensures compliance with regulatory agencies including but not limited to, The Joint Commission, NCQA, CMS, Federal and State, applicable Medical Staff Bylaws, Rules and Regulations, Policies and Procedures, and delegated contracts and/or other contracts as applicable.

Specific Duties and Responsibilities include the following:

Supervised by:

Medical Staff Services Director or Manager

Specific Duties and responsibilities include:

  • General Administrative support to the Department: 10%

  • Monitor the main virtual phone line as needed for the department and direct callers as appropriate.

  • Process incoming and outgoing faxes.

  • Respond to requests for retrieving files from storage.

  • Serves as a Liaison for the Medical Staff Services Department: 40%

  • Process the requests of the departments to initiate a medical or allied professional staff application and launches electronic applications to applicants as applicable.

  • Collaborate with practitioners, departments and staff to collect and verify information to appropriately update practitioner profile data in the credentialing software program when applicable.

  • Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.

  • Communicates the status of the files or other credentialing information directly to providers and various department representatives and/or outside organizations, clients or affiliates and coordinates efforts as applicable.

  • Utilizes the credentialing software database to track and monitor information related to Medical and Professional Allied Staff Credential Files: 10%

  • Monitor and update staff status of appointments and privileges.

  • Link electronic Delineation of Privileges to practitioner files, and release privileges into the online database.

  • Processes requests for moonlighting applications and privileges when applicable, ensuring compliance with criteria outlined in clinical privilege descriptions.

  • Actively Participate Monthly Credentials Privilege and Review Committee Process: 10%

  • Prepare the applicant credentials files for presentation to the Credentials Privilege and Review Committee as needed.

  • Prepare meeting agendas and minutes for presentation to Health System Entity Medical Staff Committees, and Hospital Boards.

  • Prepare board letters and special mailings as applicable and communicate the outcome to practitioners, and department’s representatives as applicable.

  • Performs various functions related to ongoing monitoring and tracking of credentials of the organization’s Medical staff, Allied Health Professional staff, and other Health Professional staff as delegated by outside clients for credentials: 20%

  • State license, DEA and sanction information.

  • Time limited requirements for Medical and Allied staff (e.g. Health and PPD status, sedation training, BLS, ACLS), etc.

  • Prepares and provides monthly status reports to departments, co-workers, leadership and clients regarding the status of ongoing monitoring and time limited requirements.

  • Performs miscellaneous administrative related duties as assigned. 10%

    Education:

    Associates degree or equivalent combination of education and/or experience.

    Experience:

    At least three years of secretarial and/or office experience and/or at least one year experience in health care/health plan setting.

    Occupational Skills:

    Organizational skills required to handle voluminous paper flow and to prioritize tasks in order to meet cyclical deadlines. Ability to manage demanding workload; self-motivated; able to carry out responsibilities with minimum supervision. Candidate must be flexible and work well in a team environment. Ability to work in a fast paced environment and multi-task and demonstrated skills related to achievement of customer satisfaction.

    Preferred Skills and Experience:

  • Technical Skills: Experience with Microsoft Office applications required. Experience with database applications preferred.

  • Experience: Working knowledge of general office practices and software applications and database management. Experience in credentialing and National and State regulatory requirements. Certified Provider Credentialing Specialist CPCS preferred.

    References must be current manager (s) that can provide information on decision making skills and independent judgment.

    How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

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